Brain Bleed and Blood Thinners Lawsuit

Narowanski v. Advanced Radiology

Skull FractureThis wrongful death claim was filed in Carroll County after physicians failed to notice cranial bleeding on a man's head CT and prescribed anticoagulants to treat the blood clots in his lungs. It was filed in Health Claims Arbitration on January 19, 2018, and it is the 33rd medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

A man was using a tractor to shovel snow from his driveway when he was hit by a passing vehicle. He was thrown from his seat and pinned under the tractor's front bucket, and he was taken by ambulance to Carroll Hospital. The man had no memory of the accident but complained of right shoulder, right hip, and head pain. He also exhibited swelling and bruising around his right eye and head.

Healthcare providers ordered a head CT, which showed no fractures or hemorrhage. A chest CT, however, showed defects in the pulmonary arteries that indicated pulmonary emboli (blood clots in the lungs). It would've been unusual for pulmonary emboli to appear so soon after an accident, so the emboli were attributed to the man's shoulder surgery two months prior. The healthcare providers administered anticoagulation medication (blood thinners) to treat the man's pulmonary emboli.

Two days later, the man became non-responsive and a second head CT revealed a left-sided subdural hematoma (a pool of blood just outside the brain). The man was transferred to the Shock Trauma Unit at University of Maryland Medical Center with a discharge diagnosis including the subdural hematoma, a small hemorrhage in the left temporal lobe, insufficient blood flow to the brain, a right clavicular fracture, coma, and two pulmonary emboli.

The first head CT taken at Carroll Hospital was re-examined at UMMC, where doctors could see evidence of a skull fracture with cranial bleeding. Unfortunately, the man's condition did not improve and he died one day after the transfer.

Additional Comments
  • Confusion, head pain, and bruising around the eyes and head are all classic symptoms of a skull fracture. Having clearly noted these symptoms in the medical record, plaintiff alleges the physicians should have examined his head CT more carefully for evidence of a fracture or bleeding.

  • Blood thinners are an appropriate treatment for blood clots, but they can fatally exacerbate damage if a patient is bleeding from another site. Anticoagulants made it more difficult for blood to clot in the man's lungs where emboli were obstructing blood flow, but blood in the man's brain needed to clot in order to stop flowing. It was a risky move to prescribe anticoagulants to a patient with such obvious symptoms of a skull fracture, and his physicians should have offered other treatment options. For patients who can't take blood thinners, doctors may treat emboli with a vena cava filter which keeps blood clots from traveling to the lungs.

Jurisdiction
  • Carroll County
Defendants
  • Advanced Radiology, P.A.
  • Carroll Health Group, LLC
  • Carroll Hospital Center, Inc.
  • Lifebridge Health, Inc.
  • Carroll Hospital Center Foundation, Inc.
  • Carroll Hospital Center Mob Investment, LLC
  • Carroll County Health Services Corporation
  • A radiologist
  • An ER doctor
  • Two internal medicine doctors
  • An orthopedic surgeon
Hospitals Where Patient was Treated
  • Carroll Hospital
  • University of Maryland Medical Center
Negligence
  • Failing to properly evaluate the claimant's medical condition.
  • Failing to timely diagnose and treat the claimant's cranial bleed.
  • Negligently administering anticoagulants.
Specific Counts Pled
  • As a result of medical negligence, a man suffered wrongful death.
  • The man's surviving wife and daughter suffered emotional and financial losses as a result of his death.
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